Provider Demographics
NPI:1962561506
Name:ZIEBOLD, CHRISTINE S (MD, PHD,MPH)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:S
Last Name:ZIEBOLD
Suffix:
Gender:F
Credentials:MD, PHD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-2270
Mailing Address - Fax:319-356-4855
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-2270
Practice Address - Fax:319-356-4855
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA369942080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0761213Medicaid
IA29487OtherWELLMARK BCBS
IAI19229Medicare PIN
IA29487OtherWELLMARK BCBS